Had under eye filler twice, what is this line under my eye? (Photos)

Question

I have gotten under eye filler twice. The second time my doctor pointed out a line under my eye that he said could made worse with filler. I last got filled 9 months ago. Lately the line has been much more noticeable and others have noticed it as well. My doctor said he could dissolve the filler but it may make it worse. He also said more filler won't help. Please help.

Nima Shemirani, MD · Answer

Hi @Reserved274106. It appears that the filler was placed too superficially. I recommend dissolving the area with Hyaluronidase.

Best of luck,

Dr. Nima

John Michael Thomassen, MD · Answer

This may be some residual hyaluronic acid filler that has remained.  Many options exist including dissolving the filler or filling around this area with fat grafting.

Eric M. Joseph, MD · Answer

If you have a visible area of ha filler, I'm not sure why your doctor feels that dissolving it could make the condition worse. The raised area appears to be in the location of under eye grooves that may be treated with fillers. If this line is from overcorrection, the options include dissolving enzyme, steroid injections, direct excision, or perhaps Morpheus 8. If you have a photograph of your left under eye before any treatment, please consider re-asking your question with before and after photos. I hope this is helpful. Sincerely, Dr Joseph

Michael A. Persky, MD · Answer

Hi R,
The elevated line that is visible is likely filler.  I would treat you by dissolving the filler.  The under eye area is very delicate and should only be treated by an expert aesthetic physician injector.  Good luck and be well.
Michael Persky, MD
Encino, CA

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Robinson Facial Plastic Surgery - Alpharetta · Answer

Hi there! I'm so sorry you are having this experience with your under eye filler. This, by far, is one of the most rewarding, yet challenging areas to fill. From your photo, it appears that there is a small linear thread of filler that was injected a little too superficially. 
My first recommendation is to attempt to massage it down. It takes a good bit of pressure to be able to massage filler down, and being that this was done 9 months ago, this may not make any difference, but I would try nonetheless, because it is the least invasive thing you can try. If this does not work, without a doubt, I would inject a little Hylenex (dissolving agent) right where that line is. This will likely erase it within minutes, and I really cannot think of any reason to not attempt this. If this line was not present 9 months ago, this is likely filler, and can therefore be dissolved.
Lastly, sometimes when attempting to fill the tear troughs, the zygomatic cutaneous ligament is affected and gives the appearance of a ridge that runs from the inner corner of the eye to about an inch down the mid cheek. This however, is more visible when a patient is smiling, which you do not appear to be in your photo, so I do not believe this to be the issue. 
I hope this helps!

Bruce K. Smith, MD · Answer

The line in the photos looks like filler that was injected to superficially in the skin. Dissolve it with hyaluronidase and start over with a deeper injection of filler.

Darryl J. Blinski, MD · Answer

Nice posted photos of the tear trough area which was poorly injected with HA filler. You need to see in person or virtually a true expert in injecting HA filers. Expect a few office sessions to correct. And fees in the $1,000+ ranges.

Onir Spiegel, DDS, PhD · Answer

When getting under eye fillers you need to know that the skin is very thin and the filler can find its way to the surface. In such cases, injecting a little  hyaluronidase will open the filler which is then massaged it into place. Once you get under eye fillers I recommend to start working on thickening the skin in the area with good product as well as modalities like Morpheus and IPL.

Leonard Grossman, MD · Answer

Generally speaking, I am against using hyaluronic acid fillers in the lower eyelid where the skin is extremely thin, causing a Tyndall effect, which is a process of transillumination of the skin and creating a blue hue. The next problem is that the orbicularis, oculi muscle squeezes the gelatinous filler, pushing it towards the nose, creating a bag or a line that you have. Overtime this tends to get worse and worse. In most people, excess hyaluronic acid can be dissolved gently and be replaced with fat grafting. Fat grafting when done properly by an expert plastic surgeon produces natural and permanent results. I hope this helps and good luck from New York City Plastic Surgery.

Had under eye filler twice, what is this line under my eye? (Photos)

Answers (11)

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